Safe and high-quality care for patients with cognitive impairment

Cognitive impairment impedes communication, attention, memory, thinking and problem solving. A person may not be able to carry out tasks or be unable to recognise people or objects. This can be temporary or permanent and will affect what the person can understand and how they relate to others and interpret the environment.

Dementia and delirium are the two most common conditions associated with cognitive impairment. People with dementia are also at a greater risk of developing delirium. People may also be cognitively impaired due to an acquired brain injury, a stroke, or intellectual disability. Any form of cognitive impairment needs to recognised, understood and acted on.

For some people with cognitive impairment and for their carers and families, a hospital stay can be a negative experience. Staff can also struggle to provide the right care in the absence of appropriate education and training. Cognitive impairment in hospital is often associated with adverse outcomes, including functional decline, increased risk of falls, increased morbidity and mortality. These adverse outcomes can lead to a longer length of stay in hospital and an increased risk of entry into residential care.

Cognitive impairment is currently under-recognised in Australian hospitals, leading to significant safety and quality issues. However, harm can be minimised if cognitive impairment is recognised and care is tailored to the needs of the patient.

There are evidence-based ways to improve the care of patients with cognitive impairment in acute care and considerable work is under way within health systems at all levels to implement these improvements. The Commission through the Cognitive Impairment Program is coordinating work to support a systematic approach to improving the safety and quality of care for people with a cognitive impairment in hospital. The main areas of work are: